Rational use of PPE

Department of Microbiology
Zydus Medical College & Hospital
Dahod
How to optimize the availability of
personal protective equipment (PPE)?

1. Minimize the need for PPE: (Table-1)

• Hand hygiene remains one of the most important measures

• Wearing a medical mask is one of the prevention measures to

limit spread of certain respiratory diseases, including 2019-nCoV,
is useful when worn by the persons suffering from the disease or
contacts of the patients.
2. Ensure PPE use is rationalized and appropriate
• PPE should be used based on the risk of exposure (e.g., type of
activity) and the transmission dynamics of the pathogen (e.g.,
contact droplet or aerosol).
• Use of a mask alone is insufficient to provide the adequate level
of protection and other equally relevant measures should be
adopted.
• For asymptomatic individuals, wearing a mask of any type is not
recommended.
• Wearing medical masks when they are not indicated may cause:
•Unnecessary cost and a procurement burden
•Create a false sense of security that can lead to the neglect of
other essential preventive measures such as hand hygiene.
Table 1. Recommended type of personal protective equipment
(PPE) to be used in the context of COVID-19 disease, according
to the setting, personnel and type of activity.
Setting Target personnel or Activity Type of PPE or procedure
Patients
Healthcare facilities
Inpatient facilities
Providing direct care to Medical mask Gown
Patient room Healthcare COVID-19 patients. Gloves
workers Eye protection (goggles or face
shield).
Aerosol-generating Respirator N95 or FFP2
procedures performed on standard, or equivalent.
COVID-19 patients. Gown Gloves
Eye protection
Apron
Cleaners Entering the room of Medical mask Gown
COVID-19 Heavy duty gloves
patients. Eye protection (if risk of splash
from organic material or
chemicals).
Boots or closed work shoes
Visitors Entering the room of a Medical mask Gown
COVID-19 patient Gloves
Other areas of All staff, including Any activity that does
patient transit (e.g., healthcare not involve contact with No PPE required
wards, corridors). workers. COVID-19
patients.

Preliminary screening Maintain spatial distance

Triage Healthcare workers not of at least 1 m.
involving direct contact No PPE required

Patients with Maintain spatial distance

respiratory Any of at least 1 m.
symptoms. Provide medical mask
if tolerated by
patient.

Patients without Any No PPE required

respiratory
symptoms.
Setting Target personnel Activity Type of PPE or
or procedure
patients

Laboratory Lab technician Manipulation of Medical mask Gown

respiratory samples. Gloves
Eye protection (if risk
of splash)
Administrative All staff, including Administrative tasks No PPE required
areas healthcare that do not involve
workers. contact with COVID-19
patients.
 Outpatient facilities
Consulta Healthcare Physical examination of Medical mask Gown
tion workers patient with respiratory Gloves
room symptoms. Eye protection

Healthcare Physical examination of PPE according to standard

workers patients without precautions and risk assessment.
respiratory symptoms.
Patients with Any Provide medical mask if
respiratory tolerated.
symptoms.
Patients without Any No PPE required
respiratory
symptoms.
Cleaners After and between Medical mask Gown
consultations with Heavy duty gloves
patients with Eye protection (if risk of splash
respiratory symptoms. from organic material or
chemicals).
Boots or closed work shoes
Waiting room Patients with respiratory Any Provide medical mask if
symptoms. tolerated.
Immediately move the patient
to an isolation room or separate
area away from others; if this is
not feasible, ensure spatial
distance of at
least 1 m from other patients
Any No PPE required
Setting Target personnel or Activity Type of PPE or
patients procedure
Administrative All staff, including Administrative No PPE required
areas tasks
healthcare workers.
Triage Healthcare workers Preliminary -Maintain spatial
screening not distance of at
involving direct least 1 m.
contact. -No PPE required
Patients with Any - Maintain spatial
respiratory distance of at
symptoms. least 1 m.
-Provide medical
mask if tolerated.
Patients without Any No PPE required
respiratory
symptoms.
Community
Home Patients with Any Maintain spatial distance
respiratory of at least 1 m.
symptoms. Provide medical mask if
tolerated, except when
sleeping.

Caregiver Entering the patient’s Medical mask

room, but not providing
direct care or assistance.

Caregiver Providing direct care or Gloves Medical

when handling stool, urine mask
or waste from COVID-19 Apron (if risk of splash)
patient being cared for
at home.

Providing direct care or Medical mask

Healthcare workers assistance to a COVID- 19 Gown
patient at home Gloves
Eye protection
Public Individuals Any No PPE required
areas (e.g., without
schools, respiratory
shopping symptoms
malls, train
stations).
Setting Target personnel or Activity Type of PPE or procedure
patients
Points of entry

Administrative All staff Any No PPE required

areas
First screening Maintain spatial distance of at
Screening area Staff (temperature least 1 m.
measurement) not No PPE required
involving direct contact

Second screening (i.e.,

Staff Interviewing passengers Medical mask
with fever for clinical Gloves
symptoms suggestive of
COVID-19 disease and
travel history).
Cleaning the area where Medical mask
Cleaners passengers with fever are Gown
being screened. Heavy duty gloves
Eye protection (if risk of splash
from organic material or
chemicals).
Boots or closed work shoes
Temporary Staff
isolation area Entering the isolation Maintain spatial distance
area, but not providing of at least 1 m.
direct assistance. Medical mask
Gloves

Staff, healthcare Assisting passenger Medical mask

workers being transported to a Gown
healthcare facility. Gloves
Eye protection

Cleaners Cleaning isolation area Medical mask

Gown
Heavy duty gloves
Eye protection (if risk of
splash from organic
material or chemicals).
Boots or closed work
shoes
Setting Target
personnel or Type of PPE or
patients Activity procedure
Ambulance or Healthcare Transporting suspected Medical mask
transfer vehicle workers COVID-19 patients to the Gowns Gloves
referral healthcare facility. Eye protection

Driver Involved only in driving the Maintain spatial

patient with suspected distance of at least 1 m.
COVID-19 No PPE required
disease and the driver’s
compartment is separated
from the COVID-19 patient.

Assisting with loading or Medical mask

unloading patient with Gowns Gloves
suspected COVID- 19 Eye protection
disease.
No direct contact with patient Medical mask
with suspected COVID-19, but
no separation between
driver’s and patient’s
compartments.
Patient with Transport to the referral Medical mask, if
suspected COVID-19 healthcare facility. tolerated
disease.

Cleaners Cleaning after and Medical mask Gown

between transport of Heavy duty gloves
patients with suspected Eye protection (if risk of splash
COVID-19 disease to the from organic material or
referral healthcare chemicals). Boots or closed
facility. work shoes
Setting Target Activity Type of PPE or procedure
personnel or
patients
Special considerations for rapid response teams assisting with public health investigations
Community
Any- Rapid response Interview suspected or No PPE if done remotely (e.g., by telephone or
where team confirmed COVID-19 video conference). Remote interview is the
investigators. patients or their preferred method.
contacts.

In-person interview of Medical mask

suspected or confirmed Maintain spatial distance of at least 1 m.
COVID-19 patients The interview should be conducted outside the
without direct contact. house or outdoors, and confirmed or suspected
COVID-19 patients should wear a medical mask if
tolerated.

In-person interview with Maintain spatial distance of at least 1 m.

asymptomatic contacts No PPE required
of COVID-19 patients. The interview should be performed outside the
house or outdoors. If it is necessary to enter the
household environment, use a thermal imaging
camera to confirm that the individual does not
have a fever, maintain spatial distance of at least
1 m and do not touch anything in the household
environment.
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